1. Sports Medicine 15 Using Therapeutic Modalities Thermotherapy Sports Massage By Andrew Morgan BPE/BEd

2. Using Therapeutic Modalities Must take care when you use Thermotherapy (applying heat) and Massage – legal ramifications. Assess athlete first, then decide which modality to use, based on which modality can most effectively reach the desired target tissue to achieve specific results.

3. Thermotherapy We looked at Cryotherapy (the application of ice) to treat injuries. Now we look at Thermotherapy (the application of heat). It has been used for centuries to treat traumatic injuries. However, in the treatment of musculoskeletal injuries thermotherapy has been replaced by cryotherapy.

4. Thermotherapy Heat is an energy form that increases molecular activity by conduction, convection, conversion and radiation. The body’s response to heat depends on the type of heat energy applied, the intensity of the heat energy, the duration of application, and the unique tissue response to heat. Correct amount heat must be applied…too little and there will be no effect…too much will result in further tissue damage.

5. Thermotherapy Many questions still remain unanswered when deciding what types of thermotherapy are appropriate for a given condition. Therapeutic effects of thermotherapy: decreases muscular spasms and joint stiffness, reduces pain, edema and inflammation, and increases blood flow and extensibility of collagen tissues.

6. Thermotherapy Heating contracted connective tissue permits an increase in extensibility through stretching…. Application of heat must be in association with a flexibility session.

7. Thermotherapy Both heat and cold relieve pain, stimulating free nerve endings and peripheral nerves by the secretion of endorphins. Muscle spasms caused by ischemia can be relieved by heat which increases blood flow to the area of injury. Heat allows vasodilation to occur. Ischemia: lack of blood supply to a body part

8. Thermotherapy Special considerations in the use of superficial heat (Arnheim): Never apply heat when there is a loss of sensation. Never apply heat immediately after an injury. Never apply heat when there is decreased arterial circulation. Never apply heat directly to the eyes. Never heat the abdomen during pregnancy. Never apply heat to a body part that exhibits signs of acute inflammation.

9. Thermatherapy Moist Heat Therapies Heated water is one of the most widely used therapeutic modalities in sports medicine. However, it is always difficult to control a constant temperature because of the rapid dissipation of heat. Water packs can be usually heated up to a higher temperature more than dry packs can.

10. Sports Massage Massage is defined as the systematic manipulation of the soft tissues of the body (Arnheim) Causes a great deal of physiological and psychological responses. Becoming more and more popular in the area of athletics. Movements used: gliding, stretching, percussing and vibrating. These produce specific responses in the athlete.

11. Sports Massage Massage is separated into 5 categories: Effluerage Petrissage Friction Tapotement Vibration

12. Sports Massage Mechanical responses: helps veins and lymph tissue drain, stretches superficial and scar tissue, connective tissue can also by stretched by friction massage. Physiological responses: Increases circulation, helps in removal of lactic acid, promotes the relaxation and stimulation of musculoskeletal tissue and organs. Psychological responses: the human response to touch is well documented.

13. Sports Massage Massage Strokes Effleurage or stroking is divided into light and deep methods. Light effleurage is sedative. Deep is the therapeutic compression of soft tissue, which encourages lymphatic and venous drainage.

14. Sports Massage – Effleurage a. effleurage b. hand over hand c. cross-body

15. Sports Massage Petrissage Petrissage or kneading is used primarily to loosen heavy tissue areas such as the trapezius, the ‘lats’ and the triceps muscles. Procedure consists of picking up skin between the thumb and the forefinger of each hand and rolling and twisting it in opposite directions. Whenever possible, deep muscle tissue should be gathered and lifted.

16. Sports Massage Friction Often used around the joints or other areas where the tissue is thin, or areas such as scar tissue, adhesions, muscle spasms and fascia. Action is the bracing of the hand using either the thumbs or the fingers and moving them in a circular motion – hands move in opposite directions.

17. Sports Massage Tapotement, or Percussion Cupping, hacking and pincerlike or pincing movements. Encourages blood flow in the area.

18. Sports Massage - Tapotement

19. Sports Massage Vibration Rapid movement that produces a quivering or trembling effect. It is used in sports because of its ability to relax and soothe. Manual or machine.

20. Sports Massage Deep Transverse Friction Massage or Cyriax Massage Specifically treats muscles, tendons, ligaments, and joint capsules. Move transversely across a ligament or tendon to mobilize it as much as possible – restoring muscle mobility.

21. Sports Massage – Cyriax massage a. index crossed over middle, b. Middle crossed over index c. two fingers side by side d. Opposed finger and thumb

22. Sports Massage Guidelines for Effective Massage Make athlete feel comfortable. Develop gentle approach. Stroke towards the heart whenever possible – encouraging venous and lymphatic drainage. Know when to massage. Never massage when athlete has local or general infection. Never apply massage over recent injury.